Last updated: February 2026 | Data sources: BLS, NCSBN, AAMA, ASCP, NHA
Choosing the Right Entry-Level Healthcare Certification in 2026
You want to work in healthcare but you are staring at a confusing list of certifications: CNA, LPN, MA, Phlebotomist, HHA. They all lead to healthcare jobs, but the training time, cost, salary, and career trajectory are very different.
This guide gives you the honest, side-by-side comparison so you can pick the certification that fits your goals, budget, and timeline.
Quick Comparison: All 5 Certifications at a Glance
| Factor | CNA | LPN/LVN | Medical Assistant | Phlebotomy | HHA |
|---|---|---|---|---|---|
| Training Time | 4-12 weeks | 12-18 months | 9-12 months | 4-8 weeks | 1-4 weeks |
| Training Cost | $500-$2,000 | $10,000-$20,000 | $5,000-$15,000 | $700-$3,000 | $200-$1,000 |
| Median Salary | $39,530 | $59,730 | $42,000 | $41,810 | $33,530 |
| Job Growth (2022-2032) | 4% | 6% | 14% | 8% | 22% |
| Work Setting | Nursing homes, hospitals | Hospitals, clinics, LTC | Clinics, offices | Labs, hospitals, clinics | Patient homes |
| Exam Required | Yes (written + skills) | Yes (NCLEX-PN) | Yes (CMA/RMA) | Yes (CPT/PBT) | Varies by state |
| Patient Contact | High (hands-on care) | High (clinical + meds) | Moderate (clinical + admin) | Low-moderate (blood draws) | High (home care) |
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CNA (Certified Nursing Assistant)
What CNAs Do
CNAs provide direct, hands-on patient care under the supervision of licensed nurses. Daily tasks include bathing patients, taking vital signs, assisting with mobility, feeding, toileting, and reporting changes in patient condition to nurses.
Training & Certification
- Training: 75-180 hours (4-12 weeks), varies by state
- Cost: $500-$2,000 for state-approved programs (some employers offer free training)
- Exam: Two-part exam — written (60-70 questions, 70% to pass) and clinical skills (3-5 skills, 100% accuracy required)
- Pass Rate: ~87-93% written, ~78-85% skills
Salary & Job Outlook
- Median Salary: $39,530/year ($19.01/hour)
- Top 10%: $46,910+/year
- Job Growth: 4% (about as fast as average)
- Total Jobs: ~1.4 million positions nationwide
Best For
- People who want to enter healthcare fast (weeks, not months)
- Those considering nursing school who want clinical experience first
- Students who need to work while in school
- Career changers who want to test if healthcare is right for them
Career Advancement
CNA is one of the best stepping stones in healthcare:
- CNA to LPN: 12-18 months additional training
- CNA to RN (ADN): 2 years additional training
- CNA to RN (BSN): 4 years additional training
Many nursing schools give CNA experience priority in admissions.
LPN/LVN (Licensed Practical Nurse / Licensed Vocational Nurse)
What LPNs Do
LPNs provide clinical nursing care including administering medications, wound care, inserting catheters, monitoring IVs, and developing care plans. LPNs work under the supervision of RNs and physicians but have significantly more clinical authority than CNAs.
Training & Certification
- Training: 12-18 months (diploma or certificate program)
- Cost: $10,000-$20,000 for approved programs
- Exam: NCLEX-PN (up to 150 computerized adaptive questions)
- Pass Rate: ~84% first-time for US-educated candidates
Salary & Job Outlook
- Median Salary: $59,730/year ($28.72/hour)
- Top 10%: $65,520+/year
- Job Growth: 6% (faster than average)
- Total Jobs: ~660,000 positions nationwide
Best For
- People willing to invest 12-18 months of training for significantly higher pay
- Those who want clinical authority (medication administration, wound care)
- Workers in states where LPNs have expanded scope of practice
- People who eventually want to bridge to RN through LPN-to-RN programs
CNA vs LPN: Key Differences
| Factor | CNA | LPN |
|---|---|---|
| Can administer medications | No | Yes |
| Can start IVs | No | Yes (in most states) |
| Can develop care plans | No | Yes (under RN supervision) |
| Training investment | 4-12 weeks, $500-$2K | 12-18 months, $10K-$20K |
| Salary difference | $39,530 | $59,730 (+$20,200/year) |
MA (Medical Assistant)
What Medical Assistants Do
Medical assistants are hybrid clinical-administrative workers. On the clinical side, they take vital signs, prepare patients for exams, draw blood, and assist with procedures. On the administrative side, they schedule appointments, manage medical records, handle billing, and process insurance.
Training & Certification
- Training: 9-12 months (certificate or diploma program); some 2-year associate degree programs exist
- Cost: $5,000-$15,000 for accredited programs
- Exam: CMA (AAMA) or RMA (AMT) — not required in all states but strongly preferred by employers
- Pass Rate: ~63-70% for CMA exam
Salary & Job Outlook
- Median Salary: $42,000/year ($20.19/hour)
- Top 10%: $50,580+/year
- Job Growth: 14% (much faster than average — one of the fastest growing healthcare jobs)
- Total Jobs: ~740,000 positions nationwide
Best For
- People who want a mix of clinical and office work
- Those who prefer working in outpatient clinics and doctor's offices (no overnight shifts)
- Workers who enjoy front-office tasks (scheduling, billing, insurance)
- People who want strong job security with 14% projected growth
CNA vs Medical Assistant: Key Differences
| Factor | CNA | Medical Assistant |
|---|---|---|
| Work environment | Hospitals, nursing homes (24/7) | Clinics, offices (M-F daytime) |
| Patient care type | Extended, hands-on (bathing, feeding) | Brief, task-oriented (vitals, blood draw) |
| Administrative duties | Minimal | Significant (billing, scheduling, records) |
| Night/weekend shifts | Very common | Rare |
| Training time | 4-12 weeks | 9-12 months |
Phlebotomy Technician
What Phlebotomists Do
Phlebotomists specialize in drawing blood for testing, transfusions, research, and donations. They also prepare and label specimens, maintain equipment, and verify patient identity. It is a narrow but essential healthcare role.
Training & Certification
- Training: 4-8 weeks (certificate program); some community college programs are 1 semester
- Cost: $700-$3,000 for approved programs
- Exam: CPT (ASCP) or PBT (ASCP) — certification is required or preferred in most states
- Pass Rate: ~75-80% for CPT exam
Salary & Job Outlook
- Median Salary: $41,810/year ($20.10/hour)
- Top 10%: $50,490+/year
- Job Growth: 8% (faster than average)
- Total Jobs: ~350,000 positions nationwide
Best For
- People who want a very fast entry into healthcare (comparable to CNA)
- Those who are comfortable with blood and needles (this is the whole job)
- Workers who prefer technical, procedure-based work over extended patient care
- People interested in laboratory science careers
CNA vs Phlebotomy: Key Differences
| Factor | CNA | Phlebotomy |
|---|---|---|
| Scope of work | Broad (many patient care tasks) | Narrow (blood draws and specimen handling) |
| Patient interaction | Extended, relational | Brief, procedural |
| Physical demands | Heavy (lifting, transfers) | Light-moderate (standing, repetitive motion) |
| Career advancement | Strong (CNA → LPN → RN) | Limited (phlebotomy → lab tech requires more school) |
| Salary | $39,530 | $41,810 |
HHA (Home Health Aide)
What Home Health Aides Do
HHAs provide personal care in patients' homes. Tasks include bathing, dressing, light housekeeping, meal preparation, medication reminders, and companionship. HHAs work independently (no supervisor on-site) with patients who are elderly, disabled, or recovering from illness.
Training & Certification
- Training: 75-120 hours (1-4 weeks), varies by state
- Cost: $200-$1,000 (some employers provide free training)
- Exam: Competency evaluation required in most states; formal exam varies
- Pass Rate: High (most HHA evaluations are practical assessments)
Salary & Job Outlook
- Median Salary: $33,530/year ($16.12/hour)
- Top 10%: $39,230+/year
- Job Growth: 22% (much faster than average — highest growth of all 5 certifications)
- Total Jobs: ~3.7 million positions nationwide
Best For
- People who prefer working one-on-one in private homes rather than institutions
- Those who want schedule flexibility (many HHA jobs are part-time or allow flexible hours)
- Workers who value independence (working without direct supervision)
- People in rural areas with fewer hospital/clinic job options
CNA vs HHA: Key Differences
| Factor | CNA | HHA |
|---|---|---|
| Work setting | Facilities (hospitals, nursing homes) | Private homes |
| Supervision | Direct (nurses on-site) | Remote (nurse visits periodically) |
| Clinical skills | More clinical (vitals, positioning, transfers) | More personal care (housekeeping, cooking, companionship) |
| Salary | $39,530 | $33,530 |
| Career advancement | Stronger (more recognized in healthcare) | Limited unless you also get CNA |
Which Certification Should YOU Choose?
Choose CNA If:
- You want to enter healthcare quickly (4-12 weeks)
- You plan to become a nurse (LPN or RN) eventually
- You want strong career advancement options
- You are okay with physically demanding work and shift schedules
Choose LPN If:
- You can invest 12-18 months and $10K-$20K in training
- You want significantly higher pay ($59,730 vs $39,530)
- You want clinical authority (give medications, wound care)
- You want the most direct path to RN through bridge programs
Choose Medical Assistant If:
- You want a mix of clinical and administrative work
- You prefer daytime, weekday hours in outpatient settings
- You enjoy organization, billing, and scheduling tasks
- You want one of the fastest-growing healthcare careers (14% growth)
Choose Phlebotomy If:
- You want a fast, focused certification (4-8 weeks)
- You are comfortable working with blood and needles all day
- You prefer technical, repetitive tasks over extended patient care
- You want slightly higher starting pay than CNA
Choose HHA If:
- You prefer working in private homes rather than facilities
- You value schedule flexibility and independence
- You want the certification with the fastest job growth (22%)
- You are comfortable working without on-site supervision
The Smart Strategy: Stack Certifications
Many healthcare workers hold multiple certifications to increase their value and job options:
| Combination | Why It Works |
|---|---|
| CNA + Phlebotomy | Hospitals love CNAs who can also draw blood — higher pay, more shifts |
| CNA + HHA | Work both facility and home health jobs — maximum schedule flexibility |
| MA + Phlebotomy | The gold standard for medical office work — offices pay more for dual-certified MAs |
| CNA → LPN | The classic nursing career ladder — CNA experience helps with LPN school admissions |
Cost Comparison: Return on Investment
| Certification | Training Cost | Median Salary | Time to ROI |
|---|---|---|---|
| HHA | $200-$1,000 | $33,530 | Immediate (weeks) |
| CNA | $500-$2,000 | $39,530 | 1-2 months |
| Phlebotomy | $700-$3,000 | $41,810 | 1-2 months |
| Medical Assistant | $5,000-$15,000 | $42,000 | 4-6 months |
| LPN | $10,000-$20,000 | $59,730 | 6-12 months |
CNA and HHA have the fastest return on investment because training is short and cheap. LPN has the best long-term ROI because the $20K+ salary boost over CNA/MA compounds year after year.
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Official Resources
- Bureau of Labor Statistics - Nursing Assistants
- Bureau of Labor Statistics - Licensed Practical Nurses
- Bureau of Labor Statistics - Medical Assistants
- Bureau of Labor Statistics - Phlebotomists
- Bureau of Labor Statistics - Home Health Aides
- AAMA - Medical Assisting Certification
- ASCP - Phlebotomy Certification